The inside story

Unclean endoscopes could cause infection

Three out of every 20 flexible endoscopes used to examine patients' gastrointestinal tracts and colons were improperly cleaned, a new study finds.

That 15% of endoscopes had unacceptable levels of 'bio dirt' – cells and matter from a patient's body that could pose a potential infection risk to other patients, according to the researchers.

They examined 275 flexible duodenoscopes, gastroscopes and colonoscopes used at five hospitals and found that 30%, 24% and 3%, respectively, did not pass a cleanliness rating.

"Three out of 20 is an unexpectedly high number of endoscopes failing a cleanliness criterion," said lead investigator Marco Bommarito, lead research specialist at 3M Infection Prevention Division. "Clearly, we'd like no endoscopes to fail a cleanliness rating."

In recent years, improperly cleaned endoscopes at medical facilities in the United States have resulted in thousands of patients having to be checked for HIV and hepatitis B and C. More healthcare-associated outbreaks have been linked to contaminated endoscopes than to any other medical device, the US Centers for Disease Control and Prevention have reported.

Each year between 15 million and 20 million endoscopy procedures are conducted with reusable endoscope devices to screen various parts of patients' gastrointestinal tracts and look for problems such as cancer.

Duodenoscopes examine the duodenum (the first section of the small intestine), while gastroscopes examine the stomach and colonoscopes examine the colon.

"The cleaning protocols for flexible endoscopes need improvement, such as guidelines tailored to the type of scope or identifying if there is a critical step missing in the manual cleaning process, and documented quality-control measures," Bommarito said. "These types of improvements could have a positive impact on patient safety."